can cause further inflammation of the lining of the urinary tract; enough to cause blood to appear in the urine. Thickening of the walls of the calyces can interrupt blood flow, and eventually lead to tissue damage if untreated. This damaged tissue may be replaced by fibrous scar tissue. Kidney scarring can lead to high blood pressure. Diagnosis The diagnosis is made depending on the clinical presentation of the patient. For patients that present with the classical symptoms of the disorder, specifically flank pain and hematuria, the initial tests include a urinalysis and complete blood count. Next, imaging of the affected side includes an ultrasound or CT scan of the kidney. Both of these tests would show the distension of the affected kidney. To confirm the diagnosis, a CT angiogram can be performed, which would track the vascular path over the kidney, showing that a vessel is obstructing the superior calyces. Alternatively, a physician may perform a cystoscopy with a retrograde pyelogram, which would demonstrate the level of the obstruction and rule out nephrolithiasis. For those individuals that do not present with any symptoms, hematuria may be found on an urinalysis when coming in for a routine physical. Since hematuria, to any degree, is an abnormal finding, this would lead to further imaging to diagnose its cause. This imaging would be a CT scan or a renal ultrasound, which would show evidence of hydronephrosis, and lead to the same diagnostic path as those with the classic signs and symptoms. Treatment Once the diagnosis has been made, the treatment for this disorder is a partial nephrectomy involving the affected calyces. This relieves the obstruction, but leads to the loss of nephrons and renal function. With newer microscopic techniques, surgeons are now able to re-route the renal vasculature and relieve the compression on the affected calyces, while sparing the nephrons and renal function. This technique is known as Fraley's infundibulopyelostomy. Prognosis The expected outcome for patients with this disorder is generally good. Today's surgical techniques are nearly always effective at relieving the obstruction, thus curing the individual. Consequently, there are some risks that come with having a surgical procedure done, which would need to be discussed with the attending physician. If left untreated, this disorder may result in chronic infections. This may further develop into kidney failure and/or sepsis, becoming a life-threatening situation, though this is rare. Most people can function with